Rep. Nancy Pelosi Discusses Ryan White, Reproductive Health Issues
The Kaiser Daily Reports recently interviewed Rep. Nancy Pelosi (D-Calif.) about her contributions during the last Congress and to learn about her legislative plans for the 107th Congress. Pelosi is the ranking Democrat on the Appropriations Subcommittee on Foreign Operations, the only California representative on the Appropriations Subcommittee on Labor, Health and Human Services and Education and also serves on the Permanent Select Committee on Intelligence. Pelosi is also the co-chair of the AIDS Task Force of the House Democratic Caucus. She has been active in advocating increased HIV/AIDS funding and breast cancer prevention and research. Last year she co-sponsored the Vaccines for a New Millennium Act and introduced the Microbicide Development Act of 2000, which would increase research and development on this new method of disease transmission prevention. This year she co-sponsored the Global Democracy Promotion Act of 2001, which aims to restore funding for international family planning programs, which was cut by President Bush's reinstatement of the Mexico City policy. Below is a transcript of the conversation.
Last year, Congress went through a controversial formula fight for this year's Ryan White CARE Act appropriation. Are you satisfied with the final funding formula for San Francisco?
I do consider the Ryan White CARE Act one of the greatest achievements of the Congress last year. ... It provides a foundation for care and treatment for low-income individuals, and ... I was so pleased that we were able to work out a compromise that protected San Francisco from drastic cuts. ... Certainly I had a couple of concerns about the context in which that discussion took place. The idea that [San Francisco] would be penalized for intervening early for people who are HIV-infected, rather than waiting until they are full-blown cases of AIDS, just didn't seem to make medical or fiscal sense. ... I certainly prefer the hold harmless provision [that limits HIV/AIDS funding cuts for San Francisco] in the Senate reauthorization bill, but I'm glad we were able to reach a fair compromise. ... Representative Anna Eshoo (D-Calif.) and Representative Henry Waxman (D-Calif.), two Californians on the committee, did a great job of controlling the damage.
How do you/would you like to see the Ryan White CARE Act evolve in the future?
I think the act will have to recognize that the formula should take into account HIV, and it does down the road. Hopefully we can accelerate that pace, or at least, in practice, fund according to HIV rather than just AIDS.
For years, you have worked to expand Medicaid coverage to those who are HIV positive but not yet considered disabled. Do you plan to reintroduce the Early Treatment for HIV Act, which would give states the option to expand their Medicaid programs to provide treatment for low-income, HIV-positive individuals who have not yet developed symptoms of AIDS?
I look forward to introducing it soon, hopefully with Democratic Leader Dick Gephardt (Mo.) and Sen. Robert Torricelli (D-N.J.). [Gephardt] has been very interested and has provided great leadership on this in the past, so I'm hoping that will be one of the first bills that I introduce. It will help [give] thousands of low-income people living with HIV access to the care and treatment they need to stay healthy. It contributes to the quality of their life, it keeps them healthier longer, and of course we're always optimistic that a cure is right around the corner, and we'll be ready for it. The Presidential Advisory Council on AIDS, NORA, RainbowPUSH, AIDSAction, the Human Rights Campaign, ADAP Working Group, Project Inform and the San Francisco AIDS Foundation will be among those groups urging the passage of the Early Treatment for HIV Act.
President Bush has reinstated the "Mexico City policy," which prevents USAID from allocating international family planning funds to overseas organizations that use their own money to promote or provide abortion services. What steps are international family planning advocates likely to take in response to this move?
The language in the [2001 Foreign Operations bill which repealed the "global gag" rule] was language that I wrote as a ranking Democrat on Foreign Operations at the time. Now I've moved up to [Intelligence], but I'm still on the relevant committee, and, anticipating that [President Bush] would do this, I called a meeting of many of the groups who had been supportive of eliminating the gag rule. I said [at the meeting] in December that there is a good chance that President-elect Bush will move to overturn the language we had in the bill. ... [W]e had one of the largest meetings that I've seen on this subject in the Congress. [T]hese restrictions on our international family planning assistance prevent foreign NGOs from using their own, non-U.S. money to lobby their own governments for changes in laws concerning legal abortion services. If the U.S. government tried to impose similar restrictions on U.S.-based organizations, they would, without a doubt, be unconstitutional. The global gag rule ... restrict[s] access to family planning services for poor women, which would result in more unintended pregnancies, more births, more maternal deaths and injuries, and more -- not fewer -- abortions. This isn't about abortion, this is about family planning. ... They know very well that no federal dollars internationally can be spent on performing abortions. ... If you hate abortion, you should love family planning, and this is an obstacle to that.
How do you think the nation's family planning program (Title X) will fare under HHS Secretary Tommy Thompson?
I hope it won't make a big difference. I know he's on record as to where he is on all of these issues. ... [M]aybe I'm being naive about it, but I'm more optimistic that we can prevail on Title X. The American people see the wisdom of it, and this is close to home. It's not like family planning in Africa, which is remote to them. ... I think that we'll obviously be prepared to be as persuasive as is necessary. I know what Sec. Thompson's positions have been on these issues, but I also know that he's a reasonable person. I'm concerned, as Labor-HHS is my other committee, that when we talk about stem cell research and issues of that kind, that science will prevail and not politics.
In fact, Thompson has indicated that he supports embryonic stem cell research.
I'm more interested in what George Bush has to say about it, but hopefully [Thompson] will advise him in a scientific way. ... The American people look to the National Institutes of Health and look to our scientific research with great hope, and we owe them the courage to make the distinction clear about stem cell research and anything that would be an abuse of the ethical principles that we all have regarding this.